Elm Scholar Application Form

PLEASE PRINT THIS PAGE AND MAIL TO:
Elm Shakespeare Company
PO Box 206029, New Haven CT 06520-6029
 

Position Applying For (please circle)

Acting Intern

Technical Intern

Applicant Name________________________________________________

Address______________________________________________________

City/State/Zip __________________________________________________

Telephone (____) _______________________________________________

E-Mail ________________________________________________________

Date of Birth ____/____/____ Age ___________

School _______________________________________________________

Grade (as of this fall) ____________________________________________

Parent(s) Name(s) ______________________________________________

Parent(s) Daytime Telephone (____) ________________________________

Parent(s) E-mail ________________________________________________

Please complete the following on the person submitting your letter of recommendation:

Name _______________________________________________________

Address______________________________________________________

City/State/Zip __________________________________________________

Telephone (____) _______________ E-Mail __________________________

I understand that the Elm Shakespeare Company's Internship program involves a significant commitment. I understand that I will be expected to be present throughout the entire six week program from July 23rd through the strike of the set on September 3rd (Labor Day).

Applicant Signature ________________________ Date ________________

Parent Signature___________________________ Date ________________

Additional Information:
If you have further questions regarding the Elm Scholar program or any of the Elm Shakespeare Company's education programs, please email Director of Education Keely Knudsen at: sco_ish_keely@yahoo.com or call (203) 393-1436.